Daily Healthy: American Telemedicine Association

Health Care and Marfan Syndrome

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<span style="font-family: "arial" , "sans-serif";">One of the more exotic diseases known in the medical community is called Marfan Syndrome -- a genetic disorder that affects the body’s connective tissue. Connective tissue holds all the body’s cells, organs and tissue together. It also plays an important role in helping the body properly grow and develop. <o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">Because connective tissue is found throughout the body, Marfan syndrome can affect many different parts of the body, as well. According to the Marfan Foundation, features of the disorder are most often found in the heart, blood vessels, bones, joints, and eyes. Some Marfan features – for example, aortic enlargement (expansion of the main blood vessel that carries blood away from the heart to the rest of the body) – can be life-threatening. The lungs, skin and nervous system may also be affected. Marfan syndrome does not affect intelligence.<o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">About 1 in 5,000 people have Marfan syndrome, including men and women of all races and ethnic groups. About 3 out of 4 people with Marfan syndrome inherit it, meaning they get the genetic mutation from a parent who has it. But some people with Marfan syndrome are the first in their family to have it; when this happens it is called a spontaneous mutation. There is a 50 percent chance that a person with Marfan syndrome will pass along the genetic mutation each time they have a child. Much more detailed information is found at this site: <a href="https://www.marfan.org/about/marfan">https://www.marfan.org/about/marfan</a>.<o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">According to the National Institutes for  Health (NIH), individuals with <span class="ghr-condition">Marfan syndrome</span> are usually tall and slender, have elongated fingers and toes (arachnodactyly), and have an arm span that exceeds their body height. Other common features include a long and narrow face, crowded teeth, an abnormal curvature of the spine (Scoliosis or Kyphosis), and either a sunken chest (pectus excavatum) or a protruding chest (pectus carinatum). Some individuals develop an abnormal accumulation of air in the chest cavity that can result in the collapse of a lung (spontaneous pneumothorax). <o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">A membrane called the dura, which surrounds the brain and spinal cord, can be abnormally enlarged (dural ectasia) in people with <span class="ghr-condition">Marfan syndrome</span>. Dural ectasia can cause pain in the back, abdomen, legs, or head. Most individuals with <span class="ghr-condition">Marfan syndrome</span> have some degree of nearsightedness (myopia). Clouding of the lens (cataract) may occur in mid-adulthood, and increased pressure within the eye (glaucoma) occurs more frequently in people with <span class="ghr-condition">Marfan syndrome</span> than in those without the condition.<o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">The features of <span class="ghr-condition">Marfan syndrome</span>can become apparent anytime between infancy and adulthood. Depending on the onset and severity of signs and symptoms, Marfan can be fatal early in life; however, the majority of affected individuals survive into mid- to late adulthood. More information on this health care issue is located at this website: <a href="https://ghr.nlm.nih.gov/condition/marfan-syndrome">https://ghr.nlm.nih.gov/condition/marfan-syndrome</a>. <o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">Another related NIH site that has more detailed clinical data is located here: <a href="https://www.genome.gov/19519224/learning-about-marfan-syndrome/">https://www.genome.gov/19519224/learning-about-marfan-syndrome/</a>. <o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">According to KidsHealth, </span><span style="font-family: "arial" , "sans-serif";">several different types of doctors may be involved in diagnosing and caring for someone with Marfan syndrome. They include a <strong>geneticist</strong> (a doctor who specializes in disorders of the genes), a <strong>cardiologist</strong> (heart doctor), an <strong>ophthalmologist</strong> (eye doctor), and an <strong>orthopedist</strong>(bone doctor).</span><span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;"><o:p></o:p></span></div>
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<span style="font-family: "arial" , "sans-serif";">Symptoms of Marfan syndrome may be apparent when a child is very young, while some people don't have noticeable symptoms until their teen years or even adulthood. But some people go through life never knowing they have the disease, and that can be dangerous. Getting diagnosed early means doctors can do a lot to help keep someone healthy.<o:p></o:p></span></div>
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<span style="font-family: "arial" , "sans-serif";">Teens with Marfan syndrome must be followed closely by a team of doctors. Because teens' bodies grow and change so quickly, most teens will need echocardiograms at least once a year, plus frequent eye and bone exams. This helps doctors stay on top of any new problems. </span><span style="font-family: "arial" , sans-serif;">Many of the complications of Marfan syndrome can be managed with medications and, if necessary, surgery.</span></div>
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<span style="font-family: "arial" , "sans-serif";">Doctors may prescribe special medicines called beta blockers and ARBs (angiotensin-receptor blockers), which work to lower blood pressure and reduce wear and tear on the blood vessels. This can often delay the progression of aortic dilation. If the aorta does eventually widen to a potentially dangerous size, or if valve leakage becomes a problem, a doctor may recommend surgery to repair or replace the damaged parts of the heart.<o:p></o:p></span></div>
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<span style="font-family: "arial" , "sans-serif";">Marfan syndrome affects people differently, so life is not the same for all teens who have it. Some have severe cases of Marfan syndrome and many symptoms that require lots of medical care. Others have such a mild form that they simply need to have a checkup once a year. There are lots of things people with Marfan syndrome can do to help keep themselves healthy. The most important is to avoid putting extra stress on the heart. <o:p></o:p></span></div>
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<span style="font-family: "arial" , "sans-serif";">That means avoiding any sport where there's a lot of running, physical contact, muscle straining, or the chance of getting hit in the chest — things like basketball, football, baseball, gymnastics, weightlifting, and track. One thing people who have Marfan syndrome should never do is smoke or use tobacco products. More information is available at this website: <a href="http://kidshealth.org/en/teens/marfan.html">http://kidshealth.org/en/teens/marfan.html</a>.<o:p></o:p></span></div>
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<span style="font-family: "arial" , "sans-serif";">According to the March of Dimes, </span><strong><span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">here’s what you need to know about Marfan syndrome:</span></strong><span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;"><o:p></o:p></span></div>
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<span lang="EN" style="font-family: "symbol"; mso-ansi-language: EN; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">Marfan syndrome usually is inherited. This means it’s passed from parents to children through genes.<o:p></o:p></span></div>
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<span lang="EN" style="font-family: "symbol"; mso-ansi-language: EN; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">If you or a family member has Marfan syndrome, talk to a genetic counselor to learn about the chances of your baby having it.<o:p></o:p></span></div>
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<span lang="EN" style="font-family: "symbol"; mso-ansi-language: EN; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">People with Marfan syndrome can have a range of health problems and may need special medical care.<o:p></o:p></span></div>
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<span lang="EN" style="font-family: "symbol"; mso-ansi-language: EN; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">With the right treatment, people with Marfan syndrome can live as long as people without the condition. <o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">Marfan syndrome is a birth defect. Birth defects are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. More details are located at this website: <a href="http://www.marchofdimes.org/complications/marfan-syndrome.aspx">http://www.marchofdimes.org/complications/marfan-syndrome.aspx</a>.<o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">Marfan syndrome should be diagnosed as early as possible if you suspect that your child may be symptomatic, especially if one parent is already suffering from this disease. Early diagnosis is key to preventing a serious medical situation later in the child’s physical development. Consult your doctor or a medical professional if you feel that testing should be done. <o:p></o:p></span></div>
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<span lang="EN" style="font-family: "arial" , "sans-serif"; mso-ansi-language: EN;">Until next time.<span style="color: #333333;"><o:p></o:p></span></span></div>
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One of the more exotic diseases known in the medical community is called Marfan Syndrome -- a genetic disorder that affects the body’s c...

Telemedicine, Here I Come!

2:54 AM Meme Art Studio 0 Comment

<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEObNy7Am_mjQgwoSGOB4r6KpQJwzK5rfiAGOyZA6VQbXq6BCCOasJuI3MfAVuOGl28EZiW8aQwhuZDJJdaVDi4Qe57p8uV6nG5we0u-7RFu-moTgp-csK2j_ImCWvfC3ocrTD3LIq_CkJ/s1600/telehealth.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEObNy7Am_mjQgwoSGOB4r6KpQJwzK5rfiAGOyZA6VQbXq6BCCOasJuI3MfAVuOGl28EZiW8aQwhuZDJJdaVDi4Qe57p8uV6nG5we0u-7RFu-moTgp-csK2j_ImCWvfC3ocrTD3LIq_CkJ/s1600/telehealth.png" /></a><br /><br /><div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;"><br /><span style="color: black; font-family: Arial, Helvetica, sans-serif;"><strong>By <a href="http://www.psychiatry.org/mental-health/healthy-minds-blog-contributors" target="_blank">Hind Benjelloun, MD</a> </strong></span><b><a href="https://twitter.com/hbenjelloun" target="_blank"><span style="font-family: Arial, Helvetica, sans-serif;">@hbenjelloun</span> </a></b><br /><br /><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">My decision to<br />pursue a career in telemedicine was a long process. I had a comfortable, stable<br />clinical position at a highly regarded academic center in a lively city. But I<br />kept wondering if my career needed a boost. I found myself thinking, </span><i style="font-family: Arial, Helvetica, sans-serif;">career<br />development takes risk</i><span style="font-family: Arial, Helvetica, sans-serif;">. Medicine is an ever-changing and growing field. I<br />felt that I had to embrace some changes myself if I wanted to keep up.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">Telemedicine is a relatively new discipline. The idea of<br />incorporating health care with technology, specifically the web, may have some<br />rolling their eyes or shaking their heads. But, simply put, it is the future of<br />healthcare; and it is certainly getting the buzz these days.</span></div><br /><div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;"><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">The </span><a href="http://www.americantelemed.org/home" style="font-family: Arial, Helvetica, sans-serif;" target="_blank">American Telemedicine Association</a><span style="font-family: Arial, Helvetica, sans-serif;"> is rapidly growing and developing<br />its services and its role in healthcare. Many medical and scientific<br />organizations are recognizing the importance of the discipline as well. You can<br />see it reflected in the number of publications, conference seminars, and<br />available CME. Tech gurus are predicting that the recent acquisition of Oculus<br />by Facebook will be a game changer in the tech industry and will further grow<br />telemedicine’s influence.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">So I took the plunge into a field in its infancy. I went for it.<br /> Telepsychiatry! After almost ten years at Georgetown University Medical<br />Center, I drastically shifted gears to pursue a full time career in crisis<br />telepsychiatry.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">In this career change, I have been labeled a pioneer among colleagues<br />and friends. It feels wonderful to immerse myself in such an innovative<br />healthcare movement. My healthy narcissism embraces it and it strengthens my<br />confidence in what some may call a risky career decision. Today, telepsychiatry<br />is revolutionary in the way it </span><a href="http://www.psychiatry.org/advocacy--newsroom/advocacy/government-relations/improving-access-to-mental-health-treatment" style="background-color: transparent; font-family: Arial, Helvetica, sans-serif;" target="_blank">enhances access to care</a><span style="font-family: Arial, Helvetica, sans-serif;">. And although right now<br />telepsychiatry is primarily seen as a means of engaging the rural patient<br />population, it will progress in the medical community as a future medical norm.<br />The evidence is growing and continues to demonstrate the boom of telemedicine<br />and its success.</span></div><br /><div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;"><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjn4SDQASR_rY28Gl6K0YrrAWPJElWBhLlyNNMMOvcgvXnb-_tRlK2vHpDuljiSoMxtuuKz1AaphyaPE9dS0enOD0ICgYwlgdQWxWGPjHZ6VXYe4scAVoUAQVi-Bg_nKLH9SPPURwSGPfab/s1600/telepsychiatry.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" height="111" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjn4SDQASR_rY28Gl6K0YrrAWPJElWBhLlyNNMMOvcgvXnb-_tRlK2vHpDuljiSoMxtuuKz1AaphyaPE9dS0enOD0ICgYwlgdQWxWGPjHZ6VXYe4scAVoUAQVi-Bg_nKLH9SPPURwSGPfab/s1600/telepsychiatry.png" width="200" /></span></a><span style="font-family: Arial, Helvetica, sans-serif;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: black;">Still, taking the leap into telepsychiatry had its downsides.</span></span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">Because of its youth, telemedicine lacks a number of accessible mentors<br />who can guide the process. There are few clinicians who have an “institutional”<br />knowledge of telemedicine to share. This means that other than the anecdotal<br />accounts that you may read in a journal or blog post about what it’s like to<br />venture into the world of telemedicine as a provider, there aren’t many<br />reputable sources to turn to.  I had trouble knowing what to expect.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">I started working with InSight, a national telepsychiatry provider<br />company earlier this year. As a crisis telepsychiatrist with InSight, I have<br />the ability to seamlessly transition between seeing patients at multiple<br />hospitals in multiple states back to back. Today, I love my job. But the<br />legislative hurdles I had to jump through to get going were a major headache.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">I was completely committed to offering services right away when I made<br />the decision to start practicing telepsychiatry. I was ready to go. But I had<br />no idea what kind of challenges I would encounter as I attempted to receive<br />licensing from medical boards that all work independently of each other.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">After the first hurdle of becoming licensed, I thought I had passed the finish<br />line. But to my surprise, I was back to waiting on privileges from hospitals<br />that were scrutinizing my immunization records and testing my knowledge of<br />their fire code. This all seems so frivolous and a waste of time, effort and<br />money. Didn’t they understand that I would be seeing patients </span><i style="background-color: transparent; font-family: Arial, Helvetica, sans-serif;">remotely?</i><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">When I finally began working with a regular schedule, I found myself<br />asking, why did it take so long for me to be able to actually see patients and<br />provide care?</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">The answer lies in legislation. The laws and regulations in place for<br />telemedicine are significantly outdated. Why is my medical license in one state<br />insufficient in another? Big changes are needed to reflect the advent of<br />technology’s integration into medicine. And when it comes down to it, it’s the<br />patients who suffer from these outdated practices the most.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">The shortage of psychiatric prescribers, as well as other types of<br />providers in the United States is a growing problem. Telemedicine is an<br />important way of addressing that shortage with the providers we already have.</span><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiclMyiQGopCzsiPqO7NxQbQjKsU8tZ1mTGXqS4EAn0jaMZsqIA1IaU3ffFGuqmxOhmxeVYIwkvIzqxjZURj3iLbvgB49aoRjWJIy-ujkPNrnrszlD4_AS2PLhNWDKXQVs8buFkQgqlObds/s1600/FSMB.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiclMyiQGopCzsiPqO7NxQbQjKsU8tZ1mTGXqS4EAn0jaMZsqIA1IaU3ffFGuqmxOhmxeVYIwkvIzqxjZURj3iLbvgB49aoRjWJIy-ujkPNrnrszlD4_AS2PLhNWDKXQVs8buFkQgqlObds/s1600/FSMB.png" /></a><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></div><br /><div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;"><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiclMyiQGopCzsiPqO7NxQbQjKsU8tZ1mTGXqS4EAn0jaMZsqIA1IaU3ffFGuqmxOhmxeVYIwkvIzqxjZURj3iLbvgB49aoRjWJIy-ujkPNrnrszlD4_AS2PLhNWDKXQVs8buFkQgqlObds/s1600/FSMB.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"></span></a><span style="font-family: Arial, Helvetica, sans-serif;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: black;">Thankfully, there is yet hope. The Federation of State Medical Boards<br />(FSMB) has recognized this unnecessary obstacle to patient care and the strain<br />inflicted on telemedicine as an industry.  At its annual meeting at the end<br />of April, the FSBM will vote on adopting the <a href="http://www.fsmb.org/pdf/fsmb_news_rrelease_multistate_compacts.pdf" target="_blank">federation’s Interstate Medical Licensure Compact,</a> a licensing option that would allow qualified physicians to<br />expedite licensure in all states who participate in the Compact. Telemedicine<br />as a field of practice would be transformed dramatically with the adoption of<br />the Compact. Fingers crossed.</span></span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">I am enthusiastic about potential for growth of telepsychiatry and<br />telemedicine. But I believe providers must take an active role in pioneering<br />this new form of care, and pushing for its successful implementation for the<br />people who need it—our patients.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">Bottom line—we are in this for our patients, and it is our patients who<br />will benefit the most from telemedicine and a successful reevaluation of the<br />legislation that regulates it.</span></div><br /><div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;"><br /><o:p></o:p></div><br /><a class="twitter-share-button" data-count="horizontal" data-related="APAPsychiatric" data-via="APAHealthyMinds" href="http://twitter.com/share">Tweet</a><script src="http://platform.twitter.com/widgets.js" type="text/javascript"><br /></script><br /><br /><br /><br /><br />